COVID- 19; Latent class mixed models; Long Covid symptoms; Quality of life; SARS-COV- 2; Trajectories; Adult; Aged; Female; Humans; Male; Middle Aged; Cohort Studies; Post-Acute COVID-19 Syndrome; Quality of Life; SARS-CoV-2; Surveys and Questionnaires; COVID-19/epidemiology; COVID-19/physiopathology; COVID-19/psychology; COVID-19/pathology; COVID-19/complications; COVID-19; Infectious Diseases
Abstract :
[en] [en] INTRODUCTION: Long COVID is a multisystemic, fluctuating condition inducing a high burden on affected people. Despite the existence of some guidelines, its management remains complicated. We aimed to demonstrate that symptoms after a COVID-19 infection evolve following different trajectories from the initial infection until 24 months after, to identify the determinants of these trajectories, and the quality of life of people in these trajectories.
METHODS: Study participants from the Predi-COVID cohort were digitally followed from their acute SARS-CoV-2 infection until a maximum of 24 months. Data from 10 common symptoms collected at study inclusion, and months 12, 15, and 24 awere used to create a total symptom score. Impact of symptoms on quality of life was assessed at month 24 using standardized questionnaires and ad-hoc questions. Latent classes mixed models were used to identify total score symptom trajectories and individual symptoms trajectories.
RESULTS: We included 555 participants with at least 2 different time points available during follow-up (Baseline and at least one of the M12, M15 or M24 questionnaires). We identified 2 total symptom score trajectories: T1 "Mild symptoms, fast resolution" (N = 376; 67.7%), and T2 "Elevated and persisting symptoms" (N = 179; 32.3%). The main determinants of being in T2 were: older age (OR = 1.86; p = 0.003), to be a woman (OR = 1.81; p = 0.001)), elevated BMI (OR = 3.97; p < 0.001), and the presence of multi comorbidities (OR = 2.67; p = 0.005). Symptoms impacted the quality of life more in T2 than in T1 at 24 months (high fatigue level: 64.8% vs 19.5%, altered respiratory quality of life: 42.6% vs 4.6%, anxiety: 24.1% vs 4.6%, stress: 57.4% vs 35.6%, and bad sleep: 75.9% vs 51.1%).
CONCLUSION: A third of our study population was in the T2 "Elevated and persisting symptoms" trajectory, presenting high symptom frequencies up to 24 months after initial infection, with a significant impact on quality of life. This work underlined the urgent need to better identify individuals most vulnerable to long-term complications to develop tailored interventions for them.
TRIAL REGISTRATION: Clinicaltrials.gov NCT04380987 (date of registration: 2020-05-07).
Disciplines :
Life sciences: Multidisciplinary, general & others
Author, co-author :
Fischer, Aurélie; Department of Precision Health, Deep Digital Phenotyping Research Unit, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, Strassen, L- 1445, Luxembourg. Aurelie.Fischer@lih.lu ; Université de Lorraine, Nancy, France. Aurelie.Fischer@lih.lu
Zhang, Lu; Bioinformatics Platform, Luxembourg Institute of Health, 1 A-B, Rue Thomas Edison, Strassen, L- 1445, Luxembourg
Elbéji, Abir; Department of Precision Health, Deep Digital Phenotyping Research Unit, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, Strassen, L- 1445, Luxembourg
WILMES, Paul ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Systems Ecology ; Department of Life Sciences and Medicine, Faculty of Science, Technology and Medicine, 7, Avenue Des Hauts-Fourneaux, Esch-Sur-Alzette, L- 4362, Luxembourg
Snoeck, Chantal J; Department of Infection and Immunity, Clinical and Applied Virology Group, Luxembourg Institute of Health, 29, Rue Henri Koch, Esch-Sur-Alzette, L- 4354, Luxembourg
Larché, Jérôme; Long Covid Center, Clinique du Parc, Castelnau-Le-Lez, France
Oustric, Pauline; Association #ApresJ20 Covid Long France, Lucé, France
OLLERT, Markus ; University of Luxembourg ; Department of Infection and Immunity, Luxembourg Institute of Health, 29, Rue Henri Koch, Esch-Sur-Alzette, L- 4354, Luxembourg
FAGHERAZZI, Guy ; University of Luxembourg ; Department of Precision Health, Deep Digital Phenotyping Research Unit, Luxembourg Institute of Health, 1 A-B Rue Thomas Edison, Strassen, L- 1445, Luxembourg
External co-authors :
yes
Language :
English
Title :
Trajectories of persisting Covid- 19 symptoms up to 24 months after acute infection: findings from the Predi-Covid cohort study.
FNR16954531 - CoVaLux - Covid-19, Vaccination And Longer-term Health Consequences Of Covid-19 In Luxembourg, 2021 (01/12/2021-30/11/2024) - Paul Wilmes FNR14716273 - Predi-COVID - 2020 (01/04/2020-30/06/2022) - Guy Fagherazzi
Funders :
Fonds National de la Recherche Luxembourg Luxembourg Institute of Health
Funding text :
This work was supported by the Luxembourg Government through the CoVaLux Programme and the Luxembourg Institute of Health (FNR grant number 16954531). The Predi-COVID study was supported by the Luxembourg National Research Fund (FNR) (Predi-COVID, grant number 14716273), the Andr\u00E9 Losch Foundation and by European Regional Development Fund (FEDER, convention 2018\u201304 - 026\u201321).This work was supported by the Luxembourg Government through the CoVaLux Programme and the Luxembourg Institute of Health (FNR grant number 16954531). The Predi-COVID study was supported by the Luxembourg National Research Fund (FNR) (Predi-COVID, grant number 14716273), the Andr\u00E9 Losch Foundation and by European Regional Development Fund (FEDER, convention 2018 -\u200904 -\u2009026 -\u200921).This work was supported by the Luxembourg Government through the CoVaLux Programme and the Luxembourg Institute of Health (FNR grant number 16954531). The Predi-COVID study was supported by the Luxembourg National Research Fund (FNR) (Predi-COVID, grant number 14716273), the Andr\u00E9 Losch Foundation and by European Regional Development Fund (FEDER, convention 2018\u201304 -\u2009026\u201321).
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